Dreams, Cats and the ERA

At the psychiatrists' conclave, feminist rages and sleep stages

I description of healthy functioning provided a worthy theme for last week's American Psychiatric Association convention in San Francisco. At first, however, it looked as though there might be very little of either. In demonstrations and caucuses, angry feminists denounced the association as male-dominated and hopelessly sexist. Gloria Steinem was there to push the cause, and Betty Friedan sent a message saying that she dreamed of the day when women would not need psychiatrists at all.

The immediate trigger for the feminist fury was the Equal Rights Amendment. Though many psychiatrists flaunted little ERA stickers on their name tags, A.P. A. members had voted last winter to drop the organization's boycott of states that had not ratified the amendment. That meant that next year's meeting would be held in non-ERA New Orleans. But the feminists, vowing to publicize the names of any psychiatrist who showed up in New Orleans, created such a clamor that one male doctor warned: "The A.P.A. is in big trouble." The organization's board of trustees apparently agreed. In a surprise 12-to-4 vote, it overruled the referendum results and ordered next year's convention moved to an ERA state. As an added gesture, the erstwhile chauvinists approved spending up to $25,000 to help pass the amendment.

Once the convention settled down to business, there were papers and palaver aplenty. One of the more interesting scientific sessions involved sleep and depression. It has long been known that depressed people have trouble staying asleep and tend to wake up early. And lately doctors have learned that they also launch earlier than normal people into the intense period of sleep characterized by rapid eye movements (REM) that occur under closed lids.

Studying sleep patterns, Psychiatrist David Kupfer of the Western Psychiatric Institute and Clinic in Pittsburgh made an intriguing discovery. Though such popular antidepressants as the tricyclics have been a boon to the mentally ill, they usually take several weeks to produce results. If the initial drug does not seem to work, the doctor may begin trying others--until there is nothing left but shock therapy. Kupfer, on the other hand, found that even when there is no apparent change in a patient's mood, the drug almost immediately delays the onset of dreaming.

In other words, it resets the REM sleep clock to normal even while there are still symptoms of depression. Kupfer told the convention that REM patterns could become a powerful diagnostic tool--speeding up the process of finding the right drug or identifying patients for shock therapy. Said he: "We hope to find people who are clearly not going to respond three or four months earlier than we used to."

Kupfer's work seems to provide clinical confirmation of experiments involving REM sleep in cats. Harvard's Allan Hobson told the convention that he and his colleague Robert McCarley have been able to turn on the brain cells that control REM sleep in the animals. Their trick: using drugs that mimic the action of natural chemicals. Remarkably, they extended feline REM sleep from a normal six to ten minutes to nearly three hours. The Harvard cats obviously cannot describe their dreams or indicate if they really have any. But their cycles of sleep are so like those of humans that the sleep-prone animals are proving ideal research subjects--almost as important to psychiatrists as rats, mice and pigeons are to psychologists. Said McCarley: "One of the things that hampered psychiatrists has been the difficulty of finding an appropriate animal model for depression and schizophrenia, and it looks like ours is an important model for learning how depressions come about. That is very exciting." Added Hobson: "All you need to do is alter the balance between naturally occurring substances, and the mind goes bananas."

While some researchers remain skeptical of cat-brain research, a team of psychiatrists from the National Institute of Mental Health provided strong support for it. Using a similar drug, physostigmine (which indirectly "fires" or triggers brain cells that cause REM sleep), Psychiatrists Natraj Sitaram and J. Christian Gillin produced early REM dream states in humans. When they awakened subjects and quizzed them about their reveries, they found the artificially triggered dreams indistinguishable from normal ones. The researchers think they have established objective criteria for the subjective state of depression: injecting their compounds into different people, they detected a "markedly supersensitive response"--a rapid onset of dreaming--among depressives, even those in remission, as well as those with a family history of depression. Sitaram's conclusion: such tests might tell who is depressed or likely to be.

Other reports provided reassurance that many well-publicized side effects of prescription drugs are, in fact, mild. University of Pennsylvania Psychiatrist Karl Rickels told of a one-year study showing that Valium addiction is rare and comparatively easy to overcome. T. Alan Ramsey, also of Penn, challenged the view that lithium can damage kidneys, charging that such reports were based on uncontrolled studies that failed to allow for infection or other causes of disability.

Nearly all the new research reports dealt with biochemistry and kindred disciplines. Faced with competition from nonmedical therapists, psychiatrists are clearly flocking back to their medical roots. In fact, the ERA furor provided the main relief from biology and chemistry. Stirred by the flap, Author Barbara Ehrenreich tossed away her text ("Work and Love: Can Women Have Both?") and lectured psychiatrists on their failures. Said she: "Psychiatric theory said that women could find fulfillment only through a life of child bearing and domesticity." That argument, though overstated, helped bring the change on ERA.

This file is automatically generated by a robot program, so viewer discretion is required.